Sunday, March 4, 2012

Student with spinal disorder gets new lease of life after surgery

Photo/BILLY MUTAI
Ms Jackline Nyambura, a third-year Bachelor of Commerce student at the University of Nairobi, recovers following a 10-hour spinal surgery to correct congenital scoliosis at Kenyatta National Hospital in Nairobi last week.

In Summary

Nyambura had to contend with a medical problem that was not only painful and prevented her from performing simple chores like washing dishes but also affected self-esteem

Performing basic chores like washing clothes and mopping the floor without enduring any pain are her only desires.

The university student hardly remembers the last time she had a bearable matatu ride due to a medical condition affecting her spine.

Ms Jackline Nyambura, 21, was born with a curved spine, a condition known as scoliosis.

Last week, she underwent a critical operation to correct the condition at Nairobi’s Kenyatta National Hospital (KNH).

While her peers were optimistically looking forward to the final years at campus before entering the job market, Ms Nyambura had to contend with a spinal problem that was not only painful but also affected her self-esteem.

Scoliosis had affected her posture for more than two decades and occasionally caused some pain whenever she bent to pick something or perform a task.

“Whenever I stooped, an unusual curve on my back was noticeable thus I avoided doing so in public,” she said in an interview.

She went on: “I wanted to live a normal life without the limitations caused by my curved spine.”

This University of Nairobi third year student was last week handed a lease of life after undergoing an operation thanks to a spinal project by Kenyan and visiting American doctors.

Led by KNH’s orthopaedic surgeon Richard Ombachi, the team comprised Dr Sorren Otieno of Kenya’s National Spinal Injury Hospital, and two American specialists, Dr Sean Keem of the Spine Institute and Prof Bill Taylor.

The team operated on Ms Nyambura last Wednesday, giving the student hope of a pain-free final year at campus.

From bed 43 in ward 42 at KNH, Ms Nyambura described the surgery as the perfect gift anyone could have accorded her this year.

She is currently recovering at the hospital and hopes that the two-decade medical journey and postural problems have ended.

Rather than completely exempt her from household chores, she is grateful that family members encouraged her to perform light duties and take frequent breaks.

She could only perform tasks like washing her clothes, lifting small loads and cleaning the floor in between short breaks.

She also kept away from strenuous and physically demanding activities like sports.

According to Dr Ombachi, scoliosis can impact on the quality of life by limiting ones movements, causing constant body pains, reducing respiratory function, or diminishing self-esteem.

He warns that if the abnormal curvature of the spine is in the upper back area (thorax), the distorted space can affect lung and heart function, as well as swallowing and the flow of blood into and out of the heart.

The condition is more common in women.

The available treatment options for this condition include observation, bracing, or surgery.

Orthopedic specialist Fred Otsyeno notes the condition is barely visible in most cases but severe forms there is significant disfigurement, back pain and postural fatigue.

The cause of the most common form of scoliosis, idiopathic, is unknown.

This type is described based on the age when it develops. If the person is less than three years old, it is called infantile idiopathic scoliosis.

Scoliosis that develops in children aged between three and 10 years is called juvenile idiopathic scoliosis, and those who are more than 10 years old have adolescent idiopathic scoliosis.

For patients like Ms Nyambura born with this condition, these anomalies develop at four to six weeks of gestation in the uterus.

Specific abnormalities include hemi vertebra, which is half vertebra, unsegmented bar, which is a failure of the normal separation of the individual building blocks of the spine.

“The spine grows very fast especially during adolescence thus it tends to curve more during this time,” Dr Otsyeno said, adding the condition needs to be corrected before this growing phase.

Dr Otsyeno advises on some of the early indicators that one may have a curved spine.

“If shoulders are different heights, one shoulder blade is more prominent than the other, rib cages are at different heights or an uneven waist, these could be signs of scoliosis,” he explains.

Leaning of entire body to one side can also be a sign that one has the condition, he says.

However, this can only be diagnosed after undergoing an examination known as Adam’s Forward Bend Test, where the patient is asked to lean forward with their feet together and bend 90 degrees at the waist.

Abnormal curvatures

“We are able to view any asymmetry of the trunk or any abnormal spinal curvatures on the patient,” Dr Otsyeno explains.

He notes a curve is considered significant if it is greater than 25 to 30 degrees.

Curves exceeding 45 to 50 degrees are considered severe and require more aggressive treatment like surgery, he points out.

Surgery is primarily aimed at preventing further progression of the curve and discomfort or fatigue cause as a result of the condition.

Dr Ombachi further advises that undergoing the surgery also improves the appearance of the patient and builds their self-esteem.

“The surgery involves removing the abnormal vertebra thus allowing the spine to be straightened and allowing for the adjacent portions of the spine to grow normally,” says Dr Ombachi.

Jackline can’t wait to get to full recovery and prepare for her end of semester examinations in April.

For now she can only smile as she waits to take that single step, thanks to the new lease of life.